盆底康复治疗用于压力性尿失禁中的临床分析

目的 探讨中老年压力性尿失禁采用盆底康复综合疗法的临床疗效。方法 选取到该院就诊的90例中老年压力性尿失禁患者,随机分为观察组和对照组,对照组给予主动式训练治疗,观察组给予盆底电刺激联合生物反馈治疗,观察两组的临床治疗效果。结果 观察组盆底肌力恢复总有效率（88.89%）明显高于对照组（62.22%）,观察组治疗总有效率（95.55%）明显高于对照组（64.44%）,两组对比差异有统计学意义（P〈0.05）。结论 采用盆底康复综合治疗中老年压力性尿失禁疗效确切,可有效增加患者盆底肌肉的收缩持续时间,促进盆底肌力恢复,其治疗效果明显优于单纯性训练治疗。     

电刺激联合生物反馈训练在产后盆底功能障碍治疗中的临床效果

目的探讨电刺激联合生物反馈训练在产后盆底功能障碍治疗中的应用价值。方法选取2017年11月至2019年1月安徽医科大学第二附属医院门诊收治的产后压力性尿失禁合并阴道前壁膨出患者75例,按照随机数字表法分组,试验组接受电刺激与生物反馈训练(40例),对照组行盆底功能锻炼(35例),规律治疗2个月后比较两组患者盆底肌力数值,阴道前壁Aa、Ba点的位置及尿失禁生活质量问卷评分(I-QOL);两组患者继续进行3个月的盆底功能锻炼,再次比较治疗效果。结果治疗5个月后,试验组压力性尿失禁治愈率高于对照组,差异有统计学意义(P <0. 05);两组患者的盆底肌力、阴道前壁Aa、Ba点的位置及I-QOL评分随着治疗时间的延长均较前改善(P <0. 05),组间比较,试验组优于对照组,差异有统计学意义(P <0. 05)。结论电刺激联合生物反馈治疗可以提高产妇产后盆底肌力,改善盆腔脏器脱垂及压力性尿失禁症状。     

盆底电刺激联合生物反馈配合中医药治疗中老年压力性尿失禁50例临床分析

目的探讨盆底电刺激联合生物反馈配合中医药治疗中老年压力性尿失禁的临床效果。方法选取我院2016年1月至2018年6月收治的中老年压力性尿失禁患者50例,按照随机分组的方法,将其分为研究组和对照组,每组25例,研究组给予盆底电刺激联合生物反馈配合中医药治疗,对照组给予主动式训练治疗,对比两组的治疗效果。结果研究组患者的临床总有效率达92.00%,盆底肌力总有效率达到80.00%;对照组患者临床总有效率为52.00%,盆底肌力总有效率为56.00%。研究组患者的临床疗效以及盆底肌力疗效均明显优于对照组患者,差异有统计学意义(P0.05)。结论针对中老年压力性尿失禁患者,采用盆底电刺激联合生物反馈配合中医药治疗,其效果明显优于单纯性训练治疗,值得临床推广。     

TOT联合改良盆底重建术应用于压力性尿失禁合并阴道前壁脱垂的疗效分析

目的 探讨经闭孔无张力尿道中段吊带术(TOT)联合改良盆底重建术治疗压力性尿失禁(SUI)合并阴道前壁脱垂的疗效.方法 选取SUI合并阴道前壁脱垂患者100例,随机分为研究组和对照组.对照组50例,予以TOT联合Prolift(TM)前盆底重建术;研究组50例,予以TOT联合改良盆底重建术.比较两组患者的围术期指标和临...     

经阴道治疗盆底功能障碍性疾病50例临床分析

目的探讨经阴道行盆底功能性疾病（pelvic floor dysfunction,PFD）改良术式的临床应用价值。方法选取我院2004年7月至2010年9月收治的50例子宫脱垂合并阴道膨出患者的临床资料,随机分为治疗组（25例）和对照组（25例）,对照组患者采用传统的阴式子宫切除及阴道前壁修补术治疗,治疗组患者采用改良术式即曼术式、阴道旁修补术联合中央阴道自体组织＂桥＂式修补术,随访6个月,比较2组患者的临床疗效。结果治疗组患者总有效率明显高于对照组,2组患者比较差异有统计学意义（P〈0.05）。结论对PFD患者行经阴道行盆底功能性疾病改良术式,能明显降低临床复发率,改善患者生活质量,效果满意值得在临床推广。     

盆底重建术治疗老年子宫脱垂的效果及其对盆底功能的影响分析

目的:研究行阴道子宫切除联合阴道前后壁修补术与盆底重建术治疗老年子宫脱垂的效果及其对盆底功能的影响分析.方法:按简单随机化法将2016年2月—2018年5月期间114例子老年宫脱垂患者进行分组,对照组57例行阴道子宫切除联合阴道前后壁修补术治疗,观察组57例行盆底重建术,比较两组临床效果、盆底功能影响问卷-简表7(PFIQ-7)评分、盆底功能障碍问卷-20(PFDI-20)评分、盆腔器官脱垂问卷-12(PISQ-12)评分及复发率情况.结果:术后1年末,观察组子宫脱垂分度优于对照组(P<0.05);观察组PISQ-12评分高于对照组,PFIQ-7及PFDI-20评分低于对照组(P<0.05);观察组复发率为0％,低于对照组的8.77％(P<0.05).结论:与行阴道子宫切除联合阴道前后壁修补术相比,运用盆底重建术治疗老年子宫脱垂患者效果较佳,可显著改善盆底功能障碍,且复发率低.     

盆底康复综合疗法治疗中老年压力性尿失禁临床分析

目的探讨盆底康复综合疗法治疗中老年压力性尿失禁的临床效果。方法选取该院2011年4月—2012年4月收治的中老年压力性尿失禁患者120例,按照随机分组的方法,将其分为研究组和对照组,每组60例,研究组给予盆底电刺激联合生物反馈治疗,对照组给予主动式训练治疗,对比两组的治疗效果。结果研究组患者的临床总有效率达90.00%,盆底肌力总有效率达到85.00%;对照组患者临床总有效率为66.67%,盆底肌力总有效率为63.33%。研究组患者的临床疗效以及盆底肌力疗效均明显优于对照组患者,差异有统计学意义（P〈0.05）。结论针对中老年压力性尿失禁患者,采用盆底康复综合治疗,其效果明显优于单纯性训练治疗,值得临床推广。     

盆底生物反馈电刺激治疗压力性尿失禁疗效观察

目的探讨盆底生物反馈＋电刺激疗法对压力性尿失禁的治疗效果及影响疗效的相关因素。方法回顾分析2006年12月至2010年5月间因压力性尿失禁行盆底生物反馈＋电刺激治疗患者,共13例,采用StimogynBIO2001型盆底治疗仪,随访观察治疗效果。结果13例患者经1个疗程治疗后,总有效率84．6％,治愈率53．8％。未绝经患者治疗有效率高于已绝经患者（100％w77．8％）,SUII度患者治疗有效率高于SUI1I度患者（100％vs75％）,盆底电刺激有反应型患者治疗有效率高于无反应患者（100％vs33．3％）,无反应型患者治疗前、后肛提肌肌电值差异无统计学意义（P〉0．05）。结论盆底生物反馈＋电刺激能够有效治疗压力性尿失禁,但对盆底电刺激无反应型患者疗效不佳。     

生物反馈电刺激联合盆底肌训练对产后压力性尿失禁的临床疗效分析

目的分析生物反馈电刺激联合盆底肌训练对产后压力性尿失禁的临床疗效。方法选取本院2016年3月至2017年3月收治的产后压力性尿失禁患者86例,分为对照组与观察组,各43例,对照组行盆底肌训练治疗,观察组行生物反馈电刺激联合盆底肌训练治疗,对比两组治疗后盆底肌力改善程度及尿失禁疗效。结果治疗后,观察组盆底肌力0级(1)例、Ⅰ(6)例、Ⅱ(4)例、Ⅲ(3)例、Ⅳ(9)例、Ⅴ(20)例改善程度均较高于对照组(P0.05);治疗3个月后,观察组治愈尿失禁总有效率97.67%优于对照组88.37%(P0.05)。结论对产后压力性尿失禁采用生物反馈电刺激联合盆底肌训练治疗法不但能够帮助改善尿失禁症状,还能促进产后恢复,临床可推广应用。     

改良经闭孔尿道中段悬吊术和尿道后韧带缝合术治疗压力性尿失禁

目的 对比研究改良经闭孔无张力吊带尿道中段悬吊术（TVT-O）治疗压力性尿失禁（SUI）和传统的尿道后韧带缝合尿道折叠术的临床效果。方法 选取2004年9月至2006年8月中、重度压力性尿失禁患者42例，分为两组，观察组15例，采用聚丙烯网片行改良TVT-O手术；对照组27例，行传统的阴道壁修补＋尿道折叠术。对比分析两组手术的临床效果。结果 42例患者均成功手术。均无手术并发症发生。随访时间6—24个月。观察组治愈率93．33％（14／15），有效率100％（15／15），远期并发症1例，为网片侵蚀。对照组治愈率48．15％（13／27），有效率85．18％（23／27），复发率14．81％（4／27），无远期并发症。结论 采用盆底修复柔软网片进行改良TVT-O尿道悬吊术是治疗压力性尿失禁的有效方法。传统的尿道折叠术术式简单，操作方便，不需特殊材料，术后无明显并发症，但治愈率低，临床效果不理想。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.